握力与住院老年高血压病人全因死亡的相关性研究

doi:10.3969/j.issn.1003-9198.2021.07.009

摘要/Abstract

摘要： 目的探讨握力与住院老年高血压病人全因死亡的关系。方法采用前瞻性队列研究方法,入选≥65岁住院高血压病人,记录病人基本资料、生化指标、血压、共病及多重用药情况,分别采用Katz日常生活能力量表(Katz-ADL)、MMSE、微营养评定法简表(MNA-SF)评估病人的日常生活活动能力、认知状况及营养状态,采用电子读表式握力计测量握力(kg),出院随访1年以上并记录病人全因死亡的发生情况。采用Spearman相关系数分析握力与不同性别病人各变量之间的相关性,Kaplan-Meier曲线和Cox回归模型分析握力与全因死亡风险的相关性。结果共入选病人572例,平均年龄(84.02±5.98)岁,其中男性336例(58.7%);中位随访时间为3.17(2.50, 3.75)年,随访期间共111例(19.4%)发生全因死亡。Spearman相关分析显示,在不同性别病人中,握力与年龄、Charlson共病指数呈负相关,与Hb水平及Katz-ADL、MMSE、MNA-SF评分呈正相关(P<0.05)。将握力进行四分位数分组,Kaplan-Meier曲线显示,随着握力下降,死亡风险逐渐升高(log-rank:P<0.001);Cox回归模型显示,调整混杂因素后,在男性病人中,最低握力组比最高握力组全因死亡风险显著增高(HR=2.484,95% CI:1.200～5.140,P=0.014),而在女性病人中未见明显相关性。结论在住院老年男性高血压病人中,低握力与出院后全因死亡风险相关,握力可作为一项简便易行的健康结局预测指标。

关键词: 握力, 住院病人, 老年人, 高血压, 死亡

Abstract: Objective To investigate the association between handgrip strength and all-cause mortality in the elderly inpatients with hypertension. Methods A prospective cohort study in the elderly inpatients with hypertension aged ≥65 years was conducted. The basic information, biochemical indicators, blood pressure, comorbidities and polypharmacy were recorded at admission. Activities of daily living (ADL), cognitive function and the level of nutrition were assessed by Katz-ADL, Mini-Mental State Examination (MMSE) and Mini Nutritional Assessment Short-From (MNA-SF) respectively. The handgrip strength was measured by dynamometer. After discharge, the mortality was followed up for more than 1 year. Spearman correlation coefficient was used to analyze the correlation between handgrip strength and the variables of different gender inpatients. Kaplan Meier curve and Cox regression analysis were used to analyze the correlation between handgrip strength and mortality. Results A total of 572 patients (84.02 ± 5.98 years, 58.7% men) were enrolled. During a median follow-up of 3.17 years (IQR 2.50-3.75), 111 participants (19.4%) died. Spearman correlation analysis revealed that handgrip strength was negatively correlated with age and Charlson comorbidity index, and positively correlated with hemoglobin levels, Katz-ADL, MMSE, and MNA-SF scores (P<0.05) in different genders. Handgrip strength was divided into quartile groups. The Kaplan Meier curve showed that the mortality increased with the decrease of handgrip strength (log rank: P<0.001). Cox regression analysis with adjustment for potential confounding variables showed that compared to the strongest quartile, the males in the weakest group had higher mortality(HR=2.484,95% CI:1.200-5.140,P=0.014), but this association was not found in female. Conclusions In the elderly male inpatients with hypertension, low handgrip strength is associated with the risk of all-cause mortality. Handgrip strength could be a simple and effective prognostic indicator for health outcomes.

Key words: handgrip strength, inpatients, aged, hypertension, mortality

中图分类号:

R 544.1

杨卉, 王青, 路菲, 符琳琳, 王鹏. 握力与住院老年高血压病人全因死亡的相关性研究[J]. 实用老年医学, 2021, 35(7): 696-700.

YANG Hui, WANG Qing, LU Fei, FU Lin-lin, WANG Peng. Relationship between handgrip strength and all-cause mortality in elderly inpatients with hypertension[J]. Practical Geriatrics, 2021, 35(7): 696-700.

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